Abstract: Introduction Chronic rhinosinusitis (CRS) exacerbations due to methicillin-resistant Staphylococcus aureus (MRSA) are routinely encountered. Treatment often involves intravenous antibiotics that provide only transient benefits. Mupirocin has well-recognized antistaphylococcal activity, and its nasal formulation is approved by the Food and Drug Administration for the eradication of nasal colonization with MRSA. Objective The aim of this study was to describe the use of mupirocin nasal irrigations for the treatment of CRS exacerbations due to MRSA. Materials and methods Charts of patients who received mupirocin nasal irrigations for MRSA exacerbations of CRS between January 2000 and October 2003 were reviewed. Results Forty-two MRSA-positive cultures were obtained from 24 patients (mean age, 61 years; range, 38–82 years; 15 women and 6 men). Twenty-eight episodes were  treated with mupirocin nasal irrigations and doxycycline; 4 were treated with  mupirocin nasal irrigations and trimethoprim-sulfamethoxazole, and 7 episodes were treated with mupirocin nasal irrigations alone. Patients were reevaluated at approximately 4 to 6 weeks. Repeat cultures were not obtained in 12 patients (because of clinical and endoscopic resolution). Adequate follow-up was unavailable for 3 patients, and of the 27 repeat cultures, only 1 grew MRSA. Twelve patients had at least one recurrence, with a mean number of episodes of 1.75 (range, 1–8 episodes). The mean follow-up was 11.8 months (range, 3–27 months). Conclusions Mupirocin nasal irrigations may avoid the need for intravenous antibiotics, which often provide temporary benefits and entail greater cost and morbidity. Thus, mupirocin nasal irrigations may provide a relatively simple means for the management of MRSA exacerbations of CRS.

 

     Journal Watch : H.pylori & Reccurent Aphthous Ulceration in MALT of the Pharynx, Elsheikh & Mahfouz, 2005

  1.  Reviewers wanted for otolaryngology news journal's watch page. If you are an Otolaryngologist in Africa and will like to be our journal reviewer, please feel free to email orl-mailer@otolaryngologyinafrica.net

  2.   DODA 2006, capable of advanced hearing measure, and also paediatric hearing assessment is being developed. If you requested for and got a free copy of DODA, you may also look out for this latest version dubbed DODA-i, as well as for an additional page on outcome of hearing assessment using DODA.

 3.  You may want to check out this new site dedicated to early detection of hearing loss in developing countries

 4.  A subweb of this site, dedicated to online publications of otorhinolaryngological grand round presentations across Institutions all over Africa will soon take off. The subweb once active can be accessed at http://grandround.otolaryngologyinafrica.net . Watch out, and please take advantage of this to send in your grand round presentations

 Till Next Week,

 Biodun